Facts about Social Phobia: NIMH
Article title: Facts about Social Phobia: NIMH
Conditions: Social Phobia
How Common Is Social Phobia?
- About 3.7% of the U.S. population ages 18 to 54 - approximately 5.3
million Americans - has social phobia in any given year.
- Social phobia occurs in women twice as often as in men, although a
higher proportion of men seeks help for this disorder.
- The disorder typically begins in childhood or early adolescence and
rarely develops after age 25.
What Causes Social Phobia?
Research to define causes of social
phobia is ongoing.
- Some investigations implicate a small structure in the brain called
the amygdala in the symptoms of social phobia. The amygdala is believed
to be a central site in the brain that controls fear responses.
- Animal studies are adding to the evidence that suggests social
phobia can be inherited. In fact, researchers supported by the National
Institute of Mental Health (NIMH) recently identified the site of a gene
in mice that affects learned fearfulness.
- One line of research is investigating a biochemical basis for the
disorder. Scientists are exploring the idea that heightened sensitivity
to disapproval may be physiologically or hormonally based.
- Other researchers are investigating the environment's influence on
the development of social phobia. People with social phobia may acquire
their fear from observing the behavior and consequences of others, a
process called observational learning or social modeling.
What Treatments Are Available for Social Phobia?
supported by NIMH and by industry has shown that there are two effective
forms of treatment available for social phobia: certain medications and a
specific form of short-term psychotherapy called cognitive-behavioral
therapy. Medications include antidepressants such as selective serotonin
reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as
well as drugs known as high-potency benzodiazepenes. Some people with a
form of social phobia called performance phobia have been helped by
beta-blockers, which are more commonly used to control high blood
Cognitive-behavior therapy is also very useful in treating social
phobia. The central component of this treatment is exposure therapy, which
involves helping patients gradually become more comfortable with
situations that frighten them. The exposure process often involves three
stages. The first involves introducing people to the feared situation. The
second level is to increase the risk for disapproval in that situation so
people build confidence that they can handle rejection or criticism. The
third stage involves teaching people techniques to cope with disapproval.
In this stage, people imagine their worst fear and are encouraged to
develop constructive responses to their fear and perceived disapproval.
Cognitive-behavior therapy for social phobia also includes anxiety
management training - for example, teaching people techniques such as deep
breathing to control their levels of anxiety. Another important aspect of
treatment is called cognitive restructuring, which involves helping
individuals identify their misjudgments and develop more realistic
expectations of the likelihood of danger in social situations.
Supportive therapy such as group therapy, or couples or family therapy
to educate significant others about the disorder, is also helpful.
Sometimes people with social phobia also benefit from social skills
What Other Illnesses Co-Occur With Social Phobia?
can cause lowered self-esteem and depression. To try to reduce their
anxiety and alleviate depression, people with social phobia may use
alcohol or other drugs, which can lead to addiction. Some people with
social phobia may also have other anxiety disorders, such as panic
disorder and obsessive-compulsive disorder.
For more information about social phobia and other anxiety
The Anxiety Disorders Education Program, National Institute of
6001 Executive Blvd.
Room 8184, MSC
Bethesda, MD 20892-9663
Or call 301-443-4513.
Publications and other information are also available online from
the NIMH Website at http://www.nimh.nih.gov/ or by
calling toll-free 1-88-88-ANXIETY (1-888-826-9438).
Publication No. OM-99 4171 (Revised)
Printed September 1999
Updated: December 07, 2000
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